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Clinical and radiological features of severe acute respiratory syndrome coronavirus 2 meningo‐encephalitis
Author(s) -
Freitas Gabriel R.,
Figueiredo Marcos Ravi,
Vianna Arthur,
Brandão Carlos Otávio,
TorresFilho Helio M.,
Martins Andrea F. A.,
TovarMoll Fernanda,
Barroso Paulo F.
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14687
Subject(s) - medicine , splenium , encephalitis , cerebrospinal fluid , pathology , pleocytosis , diplopia , ataxia , brain biopsy , fluid attenuated inversion recovery , lymphocytic pleocytosis , corpus callosum , white matter , magnetic resonance imaging , immunology , radiology , surgery , biopsy , virus , psychiatry
Background and purpose This case illustrates for the first time the clinical and radiological evolution of SARS‐CoV‐2 meningo‐encephalitis. Methods A case of a SARS‐CoV‐2 meningo‐encephalitis is reported. Results A 65‐year‐old man with COVID‐19 presenting with meningo‐encephalitis without respiratory involvement is described. He had fever, diarrhea and vomiting, followed by diplopia, urinary retention and sleepiness. Examination disclosed a convergence strabismus and ataxia. Cerebrospinal fluid (CSF) showed lymphocytic pleocytosis, oligoclonal bands and increased interleukin 6 level. SARS‐CoV‐2 was detected in the CSF through reverse transcriptase polymerase chain reaction, but not in nasopharyngeal, tracheal secretion and rectal samples. Brain magnetic resonance imaging showed lesions on white matter hemispheres, the body and splenium of the corpus callosum and resembling the projection of corticospinal tract, remarkably on cerebellar peduncles. Conclusions This demonstrates the challenges in diagnosing COVID‐19 in patients with neurological presentations.